Provider Demographics
NPI:1720496698
Name:HEIN, KRISTIN MICHELLE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:MICHELLE
Last Name:HEIN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:MICHELLE
Other - Last Name:HEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:715 DISCOVERY BLVD
Mailing Address - Street 2:SUIT 311
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-2287
Mailing Address - Country:US
Mailing Address - Phone:512-260-6990
Mailing Address - Fax:
Practice Address - Street 1:715 DISCOVERY BLVD
Practice Address - Street 2:SUIT 311
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2287
Practice Address - Country:US
Practice Address - Phone:512-260-6990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116266225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics